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AAGP Report
March 19, 2007
Memantine is Safe and Effective in the Treatment of Moderate to Severe Alzheimer’s Disease: An Updated Meta-Analysis
Tocco M, Olin J, Graham S, Resnick E, Perhach J
Researchers conducted a meta-analysis of 5 double-blind, placebo-controlled studies of memantine in patients with moderate
to severe Alzheimer’s disease. Cumulatively, the 5 trials included 767 patients receiving memantine and 761 receiving
placebo. 18.6% of probands receiving memantine discontinued treatment as opposed to 23.5% of patients receiving placebo.
9.8% of patients receiving memantine discontinued treatment due to adverse events as opposed to 13% of patients receiving
placebo. The meta-analysis also found significant benefits with memantine treatment over placebo on measures of behavior,
cognition, function, and global status. Poster 18
CAM Use Among Older Adults and Their Caregivers in Mental Health Clinics: Prevalence, Motivations, and Associations
Meeks T, Jeste D
Researchers surveyed 103 older adults and their caregivers to assess the 1-year prevalence of complementary and alternative
medicine (CAM) use. 72% of patients surveyed had used CAM in the previous year. Prevalence of specific therapies was
as follows: megavitamins (37%), other biological supplements(39%), mind-body practices (33%), prayer/spiritual healing
(30%). Patients most commonly cited general health/prevention, stress management, pain control, and desire for autonomy
as reasons for using CAM. No sociodemographic associations were found; however, patients using CAM had higher rates of
psychological distress and chronic pain. Poster 12
Duloxetine for Treatment Resistant Late-Life Depression
Karp J, Whyte E, Lenze E, et al
41 community dwelling subjects aged ≥60 with current major depression who had discontinued escitalopram due to
non-response, partial response, relapse, and/or medication intolerance were subsequently treated openly with escitalopram.
Full response was measured as a Hamilton Depression Scale score lower than 10 for 3 consecutive weeks. After a median
of 18.5 weeks of treatment with duloxetine, 56% of subjects met criteria for full response, 19.5% met criteria for partial
response, and 24.4% were non-responders. Poster 36
The Last Contact With a Health Professional Before Suicide: Pilot Data
Draper B, Snowdon J, Wyder M
Researchers designed a “pilot psychological autopsy” for suicide victims aged 35 or over. Interviews of
52 suicide informants identified 71 health professionals who had contact with the suicide victims within 3 months of
the victims’ deaths. Of these 71 health professionals, 40 consented to participate in the pilot study. Depressive
symptoms were found in 53% of patient contacts, the majority of these in patients 60 or younger. 25% of patients were
assessed for suicide risk—none of the older patients had been so assessed. 32% of patients with depression were
assessed for risk—of these, only 5% were identified as suicidal and only 12% had expressed thoughts of hopelessness. Poster
39
Predictors of Mental Health Service Utilization in Depressed Elderly Outpatients
Fyffe D, Hyer L, Minsky S, Kiely G, Vega W, Gara M
Researchers identified 1,179 patients who were ≥60 years, clinically diagnosed with a depressive disorder, and receiving
psychotherapy and/or medication between 2000–2005. Sociodemographic and clinical factors affecting the receipt of
intervention were assessed. The mean number of psychotherapy sessions was 8.6. The mean number of psychopharmacology sessions
was 4.6. White, Hispanic, older, divorced, and single probands were more likely to participate in psychotherapy. Probands
who were Hispanic, older, divorced, or single were more likely to receive medication. Poster 4